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Systems Analyst - EDI Management

Send to my Email Email a friend Job ID 75170 Date posted 08/02/2016
Requisition ID: 75170
  • Facility: Sharp HealthPlan
  • City: San Diego
  • Department: Finance
  • Category: IT Jobs
  • Job Status: Full-Time
  • Shift: Day Job
  • FTE: 1.0
  • Shift Start: Variable
  • Shift End Time: Variable
This position is located in Kearny Mesa, San Diego County
8-hour shift: 8:00 am – 5:00 pm, weekends as needed.
Required Skills and Qualifications
  • BA/BS in health care administration or planning, information systems, computer science or related field recommended.
  • Demonstration of professional level of knowledge of health plan operations, health plan software configuration, enrollment and claim file processing and trading partner management, and data processing environments.
  • Experience analyzing complex issues and/or requests to provide effective solutions with the ability to identify root cause, communicate options and propose solutions.
  • Knowledge of health care related EDI transaction sets.
  • Familiarity with data communications standards and system configuration.
  • Extensive knowledge of IDX, Facets, QNXT, Healthedge, HPS, and/or other administrative systems within the health plan insurance industry
Preferred Skills and Qualifications
Two years’ previous experience as systems analyst within a large Health Plan preferred

Under the direction of the Supervisor of EDI Management, the Systems Analyst-EDI Mgmt will support the Data Management staff in problem solving claims, enrollment and eligibility and other data issues and implementing new software applications, EDI formats and mappings, and developing reports and data extractions for the ultimate goal of streamlining processes and improving service to internal and external customers.
Sharp Health Plan offers a variety of coverage options that combine affordability and choice, while delivering high quality health care and personal service. We provide health insurance for companies of all sizes throughout the region. Members have access to valuable plan enhancements, such as interactive wellness resources, dental discounts and our exclusive global emergency services program.
Sharp Health Plan is San Diego’s only locally based commercial health plan. With a personal approach and a superior network of medical groups and physicians, Sharp Health Plan advocates for its members by providing unparalleled quality and access to health care services. It operates as a not-for-profit health plan, committed to delivering the best health care for the best value.
As one of the top-rated health plans in California (as measured by the CAHPS satisfaction survey), Sharp Health Plan serves a growing number of companies, large and small, in San Diego and southern Riverside counties.
Additional physical requirements of position may be discussed during interview.
Sharp HealthCare is proud to be an Equal Opportunity/Affirmative Action Employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, gender identity, transgender status, sexual orientation, protected veteran status or any other protected class.
Keywords:  Health Plan data management, finance, EDI processing, EDI transaction
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